Cocoa may help curb fatigue typically associated with MS

March 08, 2019

According to a new study, cocoa may help curb the fatigue that is typically associated with multiple sclerosis. Researchers suggest cocoa may offer an easy, safe approach to the persistent symptom, if confirmed in larger studies.

Cocoa, like dark chocolate, is rich in flavonoids – substances found abundantly in fruit and vegetables and associated with anti-inflammatory properties. It may offer a simple dietary approach to a persistent and hard to treat symptom, which affects nine out of 10 people with MS.

Previous research suggests that dark chocolate, containing between 70 and 85 percent cocoa solids, is linked with an improvement in subjectively assessed fatigue in people with chronic fatigue syndrome. This prompted the researchers at the Department of Sport Health Sciences and Social Work, Centre for Movement Occupational and Rehabilitation Sciences, Oxford Brookes Centre for Nutrition and Health, Oxford Brookes University, Oxford, UK, to see if it might also be worth exploring its potential in helping to tackle the fatigue associated with MS.

They randomly assigned 40 adults recently diagnosed with the relapsing remitting form of MS and fatigue to drink a cup of either high-flavonoid cocoa powder mixed with heated rice milk or a low-flavonoid version every day for six weeks. Participants were instructed to wait 30 minutes before taking any prescribed medication or eating or drinking anything else, but otherwise to stick to their usual diet.

Fatigue and fatigability – the speed with which mental and physical fatigue set in – were assessed before the start, at the mid-point, and at the end of the trial. Participants subjectively rated their fatigue on a scale of 1 to 10, at 10, 15, and 20 hours each day, and monitored their activity with a pedometer.

After six weeks there was a small improvement in fatigue in 11 of those drinking high-flavonoid cocoa compared with eight of those drinking the low-flavonoid version. And there was a moderate effect on fatigability, with those drinking high-flavonoid cocoa able to cover more distance during the six-minute walk test.

Those drinking the high-flavonoid version showed a 45 percent improvement in subjectively assessed fatigue and an 80 percent improvement in walking speed.

Although not objectively measured, pain symptoms also improved more in the high-flavonoid group.

Given the anti-inflammatory properties of flavonoids, they could be used alongside other approaches, such as exercise, drug treatment, and physiotherapy, to treat fatigue, they suggest.

The findings were published in the Journal of Neurology Neurosurgery & Psychiatry.